This article discusses disability and its relationship with labour force outcomes. Disability occurs when a person has an impairment or is restricted in his or her activities or participation because of health condition(s). Of particular concern are those disabilities resulting in specific restrictions which affect the core activities of self care, mobility or communication; or schooling or employment restrictions.

In 1998, there were 3.6 million people in Australia with a disability (19% of the total population), based on estimates from the ABS Survey of Disability, Ageing and Carers (SDAC). A further 3.1 million reported that they had an impairment or long-term condition that did not restrict their everyday activities. The likelihood of a person having, or developing, a disability increases with age, and is largely independent of sex. Disability rates vary from 4% for children aged 0-4 years to 84% for those aged 85 and over (graph 9.6).

Of all people with a disability, 5% live in cared accommodation (including hospitals, nursing homes, aged care hostels and cared components of retirement villages), while the remainder lived in the general community.People aged 15-64 years often participate in education and/or employment, and many have family responsibilities. If they also have a disability, this may increase the difficulty in managing all the responsibilities in their lives. Of all people aged 15-64 years, 17% had a disability. In contrast, of people aged 65 years or more, 54% had a disability.

Types of restricting impairment

An impairment, in terms of the World Health Organization's International Classification of Functioning Disability and Health (ICF), can be considered to be any loss or abnormality of body functions or structures including psychological, physiological or anatomical aspects. Data from the ABS survey have been classified to five broad types, relatable to the ICF:

psychological: nervous or emotional condition

intellectual: difficulty in learning or understanding things

head injury stroke or brain damage: with long-term effects that restrict everyday activities

sensory or speech

physical: such as chronic or recurrent pain, incomplete use of arms or fingers, disfigurement or deformity, etc.

Physical impairments are the most common of all impairment types and show a steady increase with age. Of people aged 15-64 with a disability living in the community, the proportion who reported that they were restricted by a physical impairment increased with age, from 61% for 15-24 years to 79% for those aged 55-64 years. Traffic accidents, as well as work and sporting injuries, are relatively frequent causes of this type of impairment in the 15-64 years age group.

The proportion of people with disabilities who had a sensory or speech impairment also increased with age, from 15% for 15-24 year olds to 26% for 55-64 year olds. Many people with a sensory impairment had developed industrial deafness or age-related hearing loss in the course of their working life.

In contrast, intellectual impairments are more common in younger people. This impairment type is often caused by congenital disorders such as Down Syndrome. The proportion of people with an intellectual disability declined from 32% of people aged 15-24 years to 4% of people aged 55-64 years.

How participation in employment varies by type of restricting impairment

Government policy is designed to provide services to people who are restricted in the basic activities of daily living. A number of employment assistance programs give support to people with disabilities for job search activities and/or provide ongoing support at work. Under the Commonwealth/State Disability Agreement, the Commonwealth Government has responsibility for the planning, policy setting and management of disability employment services (primarily focused on people aged 15-64 years).

The labour force participation rate of working-age people living in the community was 76%. This rate dropped to 53% for people with a disability, ranging from only 29% for those people restricted by a psychiatric impairment to 56% for those restricted by a sensory impairment (table 9.7).

9.7PEOPLE WITH A DISABILITY(a) RESTRICTED BY IMPAIRMENT - 1998

Psychological

Intellectual

Head injury, stroke or
brain damage

Sensory or speech

Physical

All with a disability(b)

All persons(b)

Labour force status

%

%

%

%

%

%

%

Employed full-time

11.3

17.1

17.3

37.2

27.6

31.0

49.1

Employed part-time

10.2

12.8

12.6

13.9

15.5

16.1

20.3

Total

21.6

29.9

30.0

51.1

43.1

47.1

69.3

Total unemployed

7.2

8.3

6.6

4.7

6.0

6.1

6.3

Participation rate

28.8

38.2

36.5

55.7

49.1

53.2

75.6

Not in the labour force

71.2

61.8

63.5

44.2

50.9

46.8

24.4

Total(c)

100.0

100.0

100.0

100.0

100.0

100.0

100

(a) People aged 15-64 and living in the community.(b) The sum of the components exceeds the total because a person can report more than one impairment.(c) Includes those for which the type(s) could not be determined.

Source: ABS data available on request, 1998 Survey of Disability, Ageing and Carers.

Need for assistance with cognitive or emotional tasks

Many people with a disability live independently within the community. They may at times need assistance in some areas of their day-to-day lives. In the 1998 SDAC people were asked whether they had difficulty performing a range of day-to-day tasks and whether they needed help with them. These tasks, such as dressing, washing, walking, understanding and communicating with others, are grouped to form a number of activities of everyday life. People may need help with one or more of these activities.

In addition, the ability of a person to make good decisions, to manage their feelings and emotions, and to establish and maintain interpersonal relationships can have a significant impact on a person's ability to access support programs (accommodation, respite, employment and others), and the outcomes of those support programs. These abilities were grouped together as cognitive or emotional tasks.

Cognitive or emotional tasks are:

establishing, developing and maintaining relations with others

managing feelings, emotions and consequent behaviour

making good decisions.

These essential day-to-day tasks make a large contribution to a person's wellbeing and can be difficult at times for anyone. People with a disability, particularly those restricted by a psychological or intellectual impairment, may experience additional difficulty with these tasks and may need help from others.

The ability of a person to gain meaningful employment can be influenced by many factors, including their ability to interact with others and to make sound decisions.

In 1998, 8% of the 2,066,700 people aged 15-64 years with a disability living in the community reported that they needed help to make friends, interact with others, or maintain relationships; 15% needed help to cope with feelings or emotions; and 14% required assistance to make decisions or think through problems (table 9.8).

People with some impairment types are more likely to have a need for assistance with cognitive or emotional tasks than others: 72% of people with a psychological impairment needed assistance with one or more of these tasks, compared to 56% of people with an intellectual impairment. Less than half (41%) of people with head injury, stroke or brain damage required this type of assistance, and this form of assistance was needed to an even lesser extent among those restricted by a sensory or speech impairment (24%) and least of all among those restricted by a physical impairment (20%).

A person may have more than one impairment type. Some of the people with a physical or sensory impairment who needed assistance with cognitive or emotional tasks had a psychiatric or intellectual impairment as well.

9.8 PEOPLE WITH A DISABILITY(a), Needing assistance with cognitive or emotional tasks - 1998

Making friends, interacting with others, or maintaining relationships

Coping with feelings or emotions

Making decisions or thinking through problems

Total with a need for cognitive or emotional assistance(b)

Total(b)

Restricting impairment

%

%

%

%

‘000

Psychological

36.9

60.4

53.8

72.3

238.8

Intellectual

28.9

35.9

47.6

56.4

213.9

Head injury, stroke or brain damage

21.6

30.6

33.0

41.3

146.4

Sensory or speech

11.8

16.5

15.7

23.9

449.3

Physical

7.4

15.4

13.4

19.7

1,535.0

All impairments(c)

8.4

15.4

13.6

20.5

2,066.7

(a) People aged 15-64 and living in the community.(b) The sum of the components exceeds the total because a person can report more than one task and/or impairment.(c) Includes those for which the type(s) could not be determined.

Source: ABS data available on request, 1998 Survey of Disability, Ageing and Carers.

Coping with feelings or emotions was most frequently reported as the area of need for assistance, ranging from 60% of people with a psychological impairment to 15% of those with a physical impairment. The least need for assistance was required with making friends, interacting with others and maintaining relationships. People with a physical impairment had the lowest need for help in each of the three tasks.

Of those who had a need for assistance with cognitive or emotional tasks because of their disability, 20% reported that they always needed such help, while 80% sometimes needed it. The highest need was among those with an intellectual impairment, with 36% of those with a need for cognitive or emotional assistance always needing help. The lowest intensity of need was among those restricted by a physical impairment, with 22% of those needing cognitive or emotional assistance reporting that they always need help.

Impairment, the need for cognitive or emotional assistance, and the level of participation in a broad range of community activities are likely to be interrelated. In 1998, people with a disability aged 15-64 years who needed cognitive or emotional assistance had lower labour force participation rates than people who did not need cognitive or emotional assistance.

The labour force participation rate declines in line with increasing need for assistance with cognitive or emotional tasks. It was lowest among those who always needed cognitive or emotional assistance (20%), was higher for those who sometimes needed cognitive or emotional assistance (41%), and was highest (47%) for people who had difficulty with at least one of the cognitive or emotional tasks but did not need help with any of them. However, people who had any difficulty with cognitive or emotional tasks were less likely to participate in the labour force than people with a disability in general (53%) (table 9.9).

9.9 PEOPLE WITH A DISABILITY(a), By labour force status - 1998

Needs cognitive or emotional assistance

Always

Sometimes

Does not, buthas difficulty

Does not and has no difficulty

All people with a disability

Labour force status

%

%

%

%

%

Employed full-time

*10.2

19.7

24.7

37.3

31.0

Employed part-time

*5.5

13.6

16.6

17.4

16.1

Total

15.7

33.3

41.3

54.7

47.1

Total unemployed

*4.5

7.5

6.1

5.9

6.1

Participation rate

20.2

40.8

47.4

60.6

53.2

Not in the labour force

79.8

59.2

52.6

39.4

46.8

Total

100.0

100.0

100.0

100.0

100.0

(a) People aged 15-64 and living in the community.

Source: ABS data available on request, 1998 Survey of Disability, Ageing and Carers.

In the 15-64 age group, people with a disability who had no recorded difficulty with any of the three cognitive or emotional tasks had a much higher participation rate (61%), though still considerably lower than the rate for the total population (76%).

There are strong moves to encourage people with a disability to greater participation in the labour force. These findings suggest that the kinds of support needed by people who require assistance with cognitive or emotional tasks should be an important consideration in the design of programs for their better labour force integration.

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